Lesions on the skin are lumps or bumps such as moles, cysts, warts or skin tags. Most are benign (non-cancerous), but if they are painful, unsightly or restrict movement, you may want to have them removed. Some skin lesions are cancerous and surgical removal is the usual treatment of choice although, where appropriate, other types of treatment may be suggested by Mr Eccles.
Most benign skin lesions do not cause serious problems, but you may want to have them removed for practical or cosmetic reasons. Surgical removal of lesions is usually only considered if other treatments such as medicines or creams and lotions are not an option. Mr Eccles will be able to discuss your options with you.
Surgery is usually recommended to remove a skin lesion that shows any sign of turning cancerous, for example, a mole that has changed shape or colour. After these have been removed, the tissue is sent to a laboratory for examination under a microscope. This is called an excision biopsy.
It is important to discuss the operation with Mr Eccles so that you know exactly what to expect. For example, a small margin of normal skin around the lesion may have to be removed as well as the lesion itself. This will leave a bigger scar than you may expect from the lesion’s size. Once you fully understand the proposed treatment, you will be requested to sign a consent form.
Minor skin lesions, such as warts, may be frozen off with liquid nitrogen (cryotherapy) or treated with chemicals that are painted on such as salicylic acid. For more precise removal or for larger lesions, surgical excision is often preferred.
Surgery to remove a skin lesion is usually a quick and straightforward procedure that does not need an overnight stay in hospital. At the Consulting Suite there is an on-site operating theatre for the removal of skin lesions under local anaesthetic. It is often possible for most patients to have a consultation with Mr Eccles and then have the lesion removed on the same day.
Mr Eccles will discuss with you the probable diagnosis and the treatment involved. He may recommend surgery the same day or he may suggest delaying the procedure.
Some lesions can be shaved down to the level of the surrounding skin, either using a surgical blade or electro-surgery. Skin tags may be simply snipped off with surgical scissors. Other lesions can be cut out entirely (excised) and the wound closed up with stitches. The stitches may be dissolvable or require removal or be a combination.
Mr Eccles may apply a dressing to the operation site, which will need to be left in place for a few days. This is not always necessary as some operation sites heal better if left uncovered.
Following treatment Mr Eccles’s practice nurses will give you post-treatment advice and will discharge you from the clinic. You will be given additional dressings as required, and any appropriate post-operative medication will be prescribed. If you are unsure of the instructions, please ask the nurse discharging you for a further explanation. It is very important that you understand and follow the written instructions after your treatment. Mr Eccles will tell you when to make a follow up appointment to review your healing and to remove sutures when necessary.
As the local anaesthetic wears off, the operation site may feel sore. Painkillers such as paracetamol will help, and should be taken as advised by your surgeon. Do not take any painkillers containing aspirin or ibuprofen as this can increase the post-operative bruising.
You should take it easy for the first few days and take special care not to bump or knock the operation site. If you have had a lesion removed from your face, it may be helpful to sleep using some extra pillows as this will help to reduce swelling and bruising. You should not apply make-up to the operation site until you have had your stitches removed. Most surgical operation sites simply need to be kept clean by daily washing with cool water. A recent wound, or one that has just had the stitches removed, should not be soaked in water.
After having a skin lesion removed, the operation site generally heals fairly quickly. This can be about two to three weeks if your lesion has been cut out, or one to two weeks if it has been shaved off.
Following skin lesion removal, predictable side effects include numbness caused by the local anaesthetic, mild pain, swelling and/or bruising around the operation site, and a scar which, depending on the location of the lesion and how much healthy skin has to be removed, may be noticeable.
Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. The main possible complications of any surgery are excessive bleeding during or soon after the operation, developing an infection and an unexpected reaction to the anaesthetic. Most people’s scars heal normally but a small percentage of people have an inherited tendency to form scars that are unusually red and raised. These are called hypertrophic or keloid scars. Mr Eccles will be able to advise you on the best way to treat these. Nerve damage that leads to a local patch of numbness can also occur as a result of an excision in an area with extensive and shallow nerve branches. This is usually temporary but can be permanent. Other complications following skin lesion removal are uncommon. The chance of problems depends on the nature of the lesion, the exact type of operation used to remove it and other factors such as your general health. Mr Eccles will be able to explain how the risks apply to you.
This type of surgery is generally performed under local anaesthetic as a day case procedure in the Consulting Suite’s on-site operating theatre. Patients can go home the same day and generally recover quickly, without too much discomfort.
Lesional excision results are usually life-long. Recurrence of lesions, especially cancers can be a problem but this is safeguarded against by sending tissue off to be analysed under a microscope and by regular follow up, if indicated. Mr Eccles will be able to guide you as to what you may expect to be achieved.